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Posting Date: 09/16/2020
Appeal Status <7>
Appeal Status <7> When Appeal Status is selected, the IVR will request and collect the following information: NPI PTAN TIN HICN or MBI Refer to the Phonetic Alphabet for assistance with speaking alpha characters [...]
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Posting Date: 11/08/2023
Determine Beneficiary Responsibility on an MSP Claim
Table of Contents Determine Beneficiary Responsibility on an MSP Claim Step 1: Review the Remittance Advice Step 2: Assess the Beneficiary’s Responsibility The MSP Patient Responsibility Formula: The Beneficiary’s Responsibility on [...]
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Posting Date: 11/09/2023
MLN Connects® Newsletter: November 9, 2023
MLN Connects® Newsletter: November 9, 2023 News CMS Roundup (Nov 3, 2023) Marriage and Family Therapists & Mental Health Counselors: Enroll in Medicare Now American Indians or Alaska Natives: Help Your Patients Achieve Optimal [...]
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Posting Date: 05/03/2022
Vein Ablation and Related Services
General Documentation Requirements for Vein Ablation and Related Services Checklist of prior authorization request (PAR) information to include: Doppler ultrasound results Documentation stating presence or absence of DVT (deep vein [...]
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Posting Date: 03/17/2016
Electrical Stimulation Therapy: Important Coverage and Documentation Reminders
Electrical Stimulation Therapy: Important Coverage and Documentation Reminders Table of Contents CPT/HCPCS: 97032 Coverage and Documentation Provider Actions Related Content [Return to Top] CPT/HCPCS: 97032 National Government [...]
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Posting Date: 02/26/2016
Documentation Reminder: Psychiatry and Psychology Services
Documentation Reminder: Psychiatry and Psychology Services Table of Contents Documentation Reminder: Psychiatry and Psychology Services Submitting Documentation Provider Actions Related Content [Return to Top] Documentation [...]
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Posting Date: 05/03/2022
Botulinum Toxin Injections
General Documentation Requirements for Botulinum Toxin Injections Prior authorization is only required when one of the required Botulinum Toxin codes (J0585, J0586, J0587, or J0588) is used in conjunction with one of the required CPT injection [...]
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Posting Date: 11/09/2023
Processing Issue Botulinum Toxin Claims Returned to Provider with 5PRIA
Part A claims that have been submitted with Botulinum J codes (J0585, J0586, J0587, J0588) have incorrectly RTP with reason code 5PRIA.
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